Effectiveness of Screening and Treatment Approaches for Schistosomiasis and Strongyloidiasis in Newly-Arrived Migrants from Endemic Countries in the EU/EEA: A Systematic Review
Por:
Agbata, EN, Morton, RL, Bisoffi, Z, Bottieau, E, Greenaway, C, Biggs, BA, Montero, N, Tran, A, Rowbotham, N, Arevalo-Rodriguez, I, Myran, DT, Noori, T, Alonso-Coello, P, Pottie, K, Requena-Mendez, A
Publicada:
1 ene 2019
Resumen:
We aimed to evaluate the evidence on screening and treatment for two parasitic infectionsschistosomiasis and strongyloidiasisamong migrants from endemic countries arriving in the European Union and European Economic Area (EU/EEA). We conducted a systematic search of multiple databases to identify systematic reviews and meta-analyses published between 1 January 1993 and 30 May 2016 presenting evidence on diagnostic and treatment efficacy and cost-effectiveness. We conducted additional systematic search for individual studies published between 2010 and 2017. We assessed the methodological quality of reviews and studies using the AMSTAR, Newcastle-Ottawa Scale and QUADAS-II tools. Study synthesis and assessment of the certainty of the evidence was performed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We included 28 systematic reviews and individual studies in this review. The GRADE certainty of evidence was low for the effectiveness of screening techniques and moderate to high for treatment efficacy. Antibody-detecting serological tests are the most effective screening tests for detection of both schistosomiasis and strongyloidiasis in low-endemicity settings, because they have higher sensitivity than conventional parasitological methods. Short courses of praziquantel and ivermectin were safe and highly effective and cost-effective in treating schistosomiasis and strongyloidiasis, respectively. Economic modelling suggests presumptive single-dose treatment of strongyloidiasis with ivermectin for all migrants is likely cost-effective, but feasibility of this strategy has yet to be demonstrated in clinical studies. The evidence supports screening and treatment for schistosomiasis and strongyloidiasis in migrants from endemic countries, to reduce morbidity and mortality.
Filiaciones:
Agbata, EN:
Univ Roehampton London, Fac Hlth Sci, London SW15 5PU, England
Univ Autonoma Barcelona, Dept Paediat Obstet Gynaecol & Prevent Med, E-08193 Barcelona, Spain
Morton, RL:
Univ Sydney, NHMRC Clin Trials Ctr, Camperdown, NSW 2050, Australia
Bisoffi, Z:
IRCCS Sacro Cuore Don Calabria Negrar, CTD, I-37024 Verona, Italy
Univ Verona, Dept Diagnost & Publ Hlth, I-37134 Verona, Italy
Bottieau, E:
Inst Trop Med, Dept Clin Sci, 155 Nationalestr, B-2000 Antwerp, Belgium
Greenaway, C:
McGill Univ, Sir Mortimer B Davis Jewish Gen Hosp, Div Infect Dis & Clin Epidemiol, Montreal, PQ H3A 0G4, Canada
Biggs, BA:
Univ Melbourne, Doherty Inst, Dept Med, Parkville, Vic 3010, Australia
RMH, Victorian Infect Dis Serv, Parkville, Vic 3050, Australia
Montero, N:
Univ Tecnol Equinoccial, Fac Ciencias Salud Eugenio Espejo, CISPEC, Quito 170509, Ecuador
Tran, A:
Univ Sydney, NHMRC Clin Trials Ctr, Camperdown, NSW 2050, Australia
Rowbotham, N:
Univ Sydney, NHMRC Clin Trials Ctr, Camperdown, NSW 2050, Australia
Arevalo-Rodriguez, I:
Univ Tecnol Equinoccial, Fac Ciencias Salud Eugenio Espejo, CISPEC, Quito 170509, Ecuador
Hosp Univ Ramon y Cajal IRYCIS, Clin Biostat Unit, Madrid 28034, Spain
CIBER Epidemiol & Publ Hlth CIBERESP, Madrid 28034, Spain
Myran, DT:
Univ Ottawa, Bruyere Res Inst, Ottawa, ON K1N 6N5, Canada
Noori, T:
European Ctr Dis Prevent & Control, Gustav III S Blvd 40, S-16973 Solna, Sweden
Alonso-Coello, P:
Biomed Res Inst St Pau, IIB Sant Pau, CIBERESP, Iberoamer Cochrane Ctr, Barcelona 08025, Spain
Pottie, K:
Univ Ottawa, Ctr Global Hlth Inst Populat Hlth, Ottawa, ON K1N 6N5, Canada
Requena-Mendez, A:
Hosp Clin Univ Barcelona, CRESIB, ISGlobal, Barcelona Inst Global Hlth, E-08036 Barcelona, Spain
Gold, Green Published
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